CBHI Blog

Crestwood Behavioral Health


Leave a comment

Building Resiliency in the Treatment of Trauma

blog-resiliencey-0616

Resiliency is the ability to recover readily from illness, depression, adversity, or the like, and is one of the cornerstones to health and recovery for individuals and communities. Trauma is an emotional and psychological result of extraordinarily stressful events that shatter a person’s sense of security, making them feel helpless and vulnerable in a dangerous world. The necessity to treat and heal trauma has never been more evident than in today’s environment and culture. In recovery services, treating, mitigating and preventing trauma is a primary expectation for us at Crestwood. It is the starting point for most people as they embark on their recovery paths. The ability to restore and build resiliency through a variety of trauma-informed techniques, including engagement, resourcing, spirituality and somatic work is the basis for this integrated trauma-approach to services.

The research in neuroscience provides a foundation for the understanding that neuroplasticity and neurogenesis enables the brain to reprogram and develop new pathways for survival and growth. This has led to an understanding that we can expand the resiliency skills, thus enabling people to be less vulnerable to re-trauma, prevent trauma and heal existing trauma.  The premise is that if you teach a person to identify and access their resilient innate abilities, aptitudes or inner wellness tools, the individual can practice using these tools as a means to heal and prevent trauma. These tools are skill-based and use a wide-range of evidence-based practices, promising practices and spiritual practices as the building blocks. The practices are integrated and enable the staff at Crestwood to walk with our clients, support and stand behind our clients and guide our clients when needed.  The skills and practices are based on the premise that you meet the client exactly where they currently are.  This methodology creates a client- centered and culturally-sensitive service model.

Recovery services now have shifted from patterns that created ongoing dependency for clients, to interventions that support resiliency, self-reliance, and prevention. This trauma-informed model of building resiliency enables our clients to become more empowered, more independent of the mental health system, and more intimately connected to their communities. As Crestwood programs seek to build resiliency in our clients, communities benefit from mitigating the trauma from occurring in the first place, reducing the likelihood of diagnosed conditions recurring, and build resiliency through the community.

Trauma-informed care approaches have been the basis of the resiliency skills building. At Crestwood we utilize these trauma-informed care approaches along with culturally-sensitive multidisciplinary approaches and integrating spiritual practices by utilizing evidence-based practices including Wellness Recovery Action Plan (WRAP), Dialectical Behavior Therapy (DBT), and Peer Providers to provide a rich source for mitigating and healing the impact of trauma for our clients.  In our Crestwood programs we will continue to work with and support our clients with developing resiliency skills to create a strong foundation from which they can build from and use in their recovery.

Contributed by: Patty Blum, PhD
Crestwood Vice President


2 Comments

Life is Worth Living

blog-life-is-0616

Rashmi Rajadhyax, Program Director at Idylwood Care Center, got up one morning and thought, “Life is worth living.”  As that thought passed through her mind she decided to wonder out of curiosity what do other people think about life in general and what kind of message are people saying to themselves on a regular basis. Are those messages positive or negative? So to find out more, she surveyed 228 people at Idylwood Care Center which included residents, staff, doctors, families and visitors and asked them what life means to them. She then comprised the list of all answers which included:

Life is Worth Living • Life is Joy • Life is Beautiful • Life is Awesome • Life is Good • Life is Struggle, through struggles of life you find yourself • Life is Amazing • Life is Interesting • Life is Full of Meaning • Life is Happiness • Life is Wonderful • Life is Difficult • Life is Cavalcade of parade • Life is Crazy • Life is Challenging • Life is Great • Life is Full of surprises • Life is Family • Life is Enjoyable • Life is Fun • Life is Living • Life is Special • Life is Exciting • Life is Better than Death • Life is Short • Life is Precious • Life is Blessing • Life is Just a Bowl of Cherries • Life is Simple • Life is Rough • Life is Rewarding • Life is Everything • Life is Splendid • Life is Important • Life is Happy • Life is a Ball • Life is Prison • Life is to be Human • Life is What you make out of it • Life is Journey • Life is a Bowl of Honey, the More you Touch it, the Sweeter it Gets • Life is Everlasting • Life is Gold • Life is Full of Stress • Life is Blessing from God • Life is a Bowl of Roses • Life is Nice  • Life is Hard • Life is Complicated • Life is an Escalator with Ups and Downs • Life is Full of Choices • Life is On • Life is Full of Miseries  • Life is Bright • Life is 10% What you Make it and 90% How you Take it

Rashmi said that it was a fun and satisfying experience to create something so simple that would inspire so much excitement and curiosity in people.  The final list was compiled and copies were handed out at the facility so everyone could share with their friends and families, and to clip on a bulletin board at work or home if they wanted to.

“What it ultimately comes down to is that life is a field of unlimited possibilities. We have choices.  Life is all these quotes at one given time and life is inclusive of all,” said Rashmi.   “Use them, share them, and get inspired by them. It doesn’t matter how you use them, if they make your day happy and bright.”

Contributed by:
Rashmi Rajadhyax, Program Director
Idylwood Care Center

(download and share the image below to inspire others)

crestwood-blog-lifeis


2 Comments

A Values-Driven Organization

blog-values-0616

A values-driven organization identifies its values through a process of self-examination.  This involves identifying the organizational purpose, the needs of the customer, assessing all strengths, deficits, and opportunities, as well as threats to the organization’s mission. It also entails taking an extensive and comprehensive 360 degree look at the entire organization, in other words, a non-compromising organizational soul-searching.

At Crestwood Behavioral Health, Inc. this self-examination involves a view of our organization, our communities, and our purpose which stems from four different perspectives.

blog-values-chart

The first view we examine is from the perspective of the organizational leadership which consists of our Board of Directors, Chief Executive Officer, Chief Financial Officer, executive leadership, program administrators and campus leadership.  Next we include our front line staff, mid-management staff and program supervisory staff.  This provides perspectives from all viewpoints in Crestwood.

The next vantage point that is vital to gaining the company’s full perspective is the client and family support system stakeholder group. This involves creating a safe space for our clients and their family voices to be heard.  The client and family are the primary voices to be listened to and it may take time, support and compassion to enable this perspective to be fully shared. At Crestwood we see this as the responsibility of the organizational leadership. One way we do this is to employ people with lived experience and have family members at the executive, management and front-line staff level job positions.

The next perspective that we include is from our county partners, customers, and the communities we provide services to. This perspective enables us to understand the needs of the community and provides the opportunity to develop and enhance meaningful relationships with our partners so we can better understand and anticipate the needs of the communities we work with.

Crestwood has developed its mission and values from gathering all of these different perspectives. Crestwood’s mission is to create a partnership with clients, employees, families, business associates and the community in caring for individuals of all ages affected by mental health issues. Together, we invest our energy to enhance the quality of life, social integration, community support and empowerment of mental health clients.  Crestwood promotes wellness and recovery by providing quality and cost-effective programs in a socially responsible manner, and works with families and communities to reduce the stigma associated with mental illness.

The values that were developed from this framework are simple and come from the heart. Crestwood’s values are family, compassion, enthusiasm, flexibility, character and commitment. It is through these values that Crestwood views all aspects of our operations. These values reflect the strength and vulnerability of Crestwood, with a focus on trauma-informed approaches with love and gratitude for the people and communities we serve and the staff and partners we work with.

Crestwood views all decisions, strategies, goals and objectives, and benchmarks for success based on these values.  Our organization is driven to achieve objectives and goals relying on the courage and strength to maintain the highest level of integrity, while honoring these shared values.

Having this values-driven perspective has allowed us to grow as partners in services with other community-based organizations such as Recovery Innovations, Turning Point and Dreamcatchers Empowerment Network. The understanding and recognition that our county and community partners provide the foundation for our services, enables Crestwood to develop community specific services, with the values of the community intertwined with Crestwood’s values.

The opening of our MHRC programs in San Diego and Chula Vista are an excellent example of involving all of these perspectives.  Crestwood worked very closely with the county and community leaders to identify the needs.  The community-based providers and hospitals helped Crestwood to find the right locations for the programs. The recruitment of employees was focused on hiring people with lived experience and allowing them to provide a strong client voice, as well having family members involved at all levels of service. We worked to include the voices of Crestwood San Diego’s and Crestwood Chula Vista’s leadership teams so that they could participate in all elements of program development, making it strong and reflecting all of Crestwood’s mission and values.

By being a values-driven organization and continuing to take a full 360 degree look at ourselves and our services, Crestwood will continue to grow and provide the best care possible for our clients and the communities we serve.

Contributed by: Patty Blum, PhD, Crestwood Vice President


Leave a comment

Healthy Food is Making a Difference

blog-healthy-0616

The Crestwood Nutrition and Wellness Initiative was started in May of 2013 under the direction of Margaret McDonald, Crestwood’s Director of Nutritional and Wellness Services.  One of the initiative’s first goals was to provide Crestwood facilities with new menus and recipes based on government guidelines and the latest nutrition research, using whole foods, rather than processed foods.

In many of our Mental Health Recovery Centers (MHRCs), we have been able to greatly reduce or eliminate therapeutic diet orders because this diet is appropriate for the vast majority of our clients, including those with diabetes, high blood pressure, and high cholesterol.  The diet is appropriate for diabetics because we keep each meal within a certain range of carbohydrates, and we offer very few concentrated sweets.  We do most of our baking with whole wheat flour and serve real sugar in small portions. The diet is appropriate for those with high blood pressure and high cholesterol because we limit saturated fat by serving red meat only once a week and serving low-fat dairy products.  We also use very little added salt, and few processed or canned goods. Dietary Directors have reported that the costs have been about the same or a bit lower than the old diet.

We offer two fish meals per week, three vegetarian meals per week, and limit red meat to one meal a week. Other meals provide lean proteins such as turkey and chicken.  The diet is high in fiber with lots of whole grains, beans, lentils, and fresh fruits and vegetables.  We include many plant sources of healthy fats such as oils, trans fat free margarines, nuts, and seeds.  Whenever possible, we avoid products with trans fats, high fructose corn syrup, and artificial colorings and sweeteners, and we make as much as possible from scratch.  We also offer meals from a variety of cultural backgrounds in order to appeal to our diverse client population.

We have been monitoring client weights, lipid profiles, and HGBA1Cs (a measure of blood sugar levels over time).  In the facilities that have implemented our menus, we have seen a gradual weight loss in some of our overweight and obese clients, and an improvement in lipid profiles and a lowering of HGBA1Cs in some clients.  Dr. Zhongshu Yang, M.D., PhD from the University of California, Davis was so impressed with the change in weights and lab results at Crestwood Sacramento Center, that she applied for a grant to do a research project on our diet. She and a graduate student, Jennifer Papac B.S., recently presented a poster on our diet at UC Davis Medical School, titled “Crestwood Nutrition and Wellness Initiative in Long-Term Psychiatric Patients.”  They concluded that after implementing the diet, there was a reduction in the percentage of obese patients and an increase in the percentage of patients in the overweight and normal weight ranges. They also concluded that patients lost a significant amount of weight over the time period looked at, and that they showed a significant decrease in Body Mass Index (BMI) over that time period.

Lastly, we have received positive feedback from Dietary Directors, kitchen staff, and the clients themselves.  Dietary Directors’ comments include, “There was some resistance at first from clients and staff, but they gradually accepted the changes and are getting excited about eating healthy”, “We are starting to see healthy weight loss and an overall change in clients’ attitudes toward making healthier choices”,  and “Clients are enjoying the meals and we are getting positive feedback.”  Clients also have their opinions about the new diet changes and made comments such as, “It’s like restaurant food”, “I feel better and it’s only been a week”, “I feel good, not so heavy”, and “I feel like I have more energy.”

Going forward, Margaret plans to develop more nutrition and exercise-related groups, for clients, as well as health related in-services for staff.  Overall, Crestwood’s ultimate goal is to continue to improve the health and wellness of both our clients and staff through educating and serving them nutritious and delicious food that will make a difference in their recovery and lives.  In the words of Hippocrates, “Our food should be our medicine and our medicine should be our food.”

Contributed by:
Margaret McDonald, M.S.
Director of Nutritional and Wellness Services